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Sunday, October 27, 2013

The Federal Centers For Disease Control (CDC) just published a reorganization announcement that creates the Field Services Branch (CGCD) an entirely new branch/ division designed to control State and Local Public Health Departments.

Simultaneously the CDC has also published plans to Federalize State and Local Health Department employees; and to add approximately 1000 medical officers to the Commissioned Corps of the United States Public Health Service.

Ostensibly the US Government / Centers For Disease Control is taking this action in preparation for the expected H7N9 Hemorrhagic Avian Influenza Pandemic. In the thought of letting no good crisis go to waste, the situation smacks of the kind of Centralized Planning and Control that all good commies and corporatists love; it also forebodes the systemic failures which injures all but the political connected.

In the end, we don't know if the two birds in a bush represented by a H7N9 Pandemic will actually hit the USA, but we do know that the reaction the government has in hand for our supposed health and safety has significant dangers all of its own.

Today the USDA placed an Environmental Impact notice on the US Federal Register that they are planning a Pandemic Animal Slaughter so massive that the current disposal methods of open pit burial and open pit burning cannot handle carcass throughput.

Specifically the USDA wants public input by Thanksgiving week, on how to handle "mass carcass management" of 50 tons or more per site. Currently they are investigating, large scale carcass composting, "rendering, landfills compliant with the Resource Conservation and Recovery Act (RCRA), and other fixed facility options, such as incinerators compliant with the Clean Air Act, that could accommodate a large volume of carcasses over a short period of time."

Thursday, October 24, 2013

Singapore just altered / tailored their Pandemic Alert system to respond to the H7N9 outbreak in China. This is a strong indication that SARS style thermal scanning checkpoints will soon appear in Singapore.

HK authorities have confirmed their thermal travel checkpoints, and an additional reported case of H7N9 in Zhejiang affecting a 67 year old man who became ill on October 16th. This is the same province where a 35 year old man also recently became deathly ill with H7N9 Bird Flu (it has been reported that he traveled overseas). It is important to note that significant parts of Zhejiang province are a disaster area from a Typhoon which came through on October 7th; as such, high levels of population displacement / travel are to be expected, some of which may be infected by H7N9 bird flu.

One additional pandemic harbinger we have noticed is the initial infection in a younger individual followed by later infection in an older individual, this may be indicative of undetected Human to Human H7N9 transmission in the population.

For these reasons this we have elevated the situation to one of high vigilance / alert.

Tuesday, October 22, 2013

The Department Of Homeland Security has a current solicitation out which looks to make heavy, priority use of the VERIZON network during National Emergencies, Disasters, Pandemics, or any other situation where the government demands priority use rights of the telecommunications infrastructure. Of course, that likely means you can expect your Verizon phone to be a paper weight when you might really need it.

As one can envision, the focus is on Pandemic Avian Influenza, however there are also Medical Counter Measures (MCM) budget line items for the whole Chemical, Biological, Radiological, and Nuclear (CBRN) threat spectrum. The mix of these line items (and how treatments overlap) increases the difficulty of figuring out specifically which scenarios the U.S. Government perceives as likely / significant threats.

But with much diligence, we have been able to look at the released solicitations and reverse decompose their requirements into the Concept of Operations which created them. When time becomes available, we will go into more detail, and provide source links for the analysis (and likely a video too). But for the moment, an executive summary of the radiological risk planning we have surmised will have to suffice.

Monday, October 21, 2013

The National Institute of Allergy and Infectious Diseases (NIAID) is seeking healthy human "ferrets" to vaccinate and then infect with various forms of Influenza A, followed by antiviral treatment. Basically they are trying to understand the things that puzzle them in regard to highly pathogenic avian influenza in humans.

There are some very unusual aspects of the recent bout of human H7N9 Avian Influenza, most of which we suspect are immunological and public pandemic response related (more on this in a future post). These unusual aspects of H7N9 infections can be seen in the conflicting nature of H7N9 transmission studies vs empirical epidemiological reports. The issue can also been seen in H7N9 case clusters where some of the cluster infected individuals have full blown H7N9 symptoms including ARDS, but have no titers for H7N9 (as well as negative testing milder cases).

Our take on the these issues is that most of these studies are not in conflict, in reality they are in violent agreement with each other; but they are not recognized as such because of poor Design Of Experiments, and poor or non-existent Decision Analysis.

That said, we do suspect there maybe and should be some serious concerns about the unintended pandemic outcomes of using current vaccine technology to trigger immune responses to viruses which Darwin has chosen the human body not to easily titer to. such as H7N9.

We don't know how much NIAID is going to pay these volunteers or what kind of cages they are going to keep these people in, we just know we don't want to be volunteered for it. But, those of you interested can read much more in the government CRAD contract associated with it, seeSolicitation Number: NIAID-TTIPO-2012-002

"Xinhua Hong Kong, Oct. 19 (Xinhua) (Reporter Zhang Ascott) HKSAR Government Food and Health Bureau, Ko Wing-man on the 19th, said that with the onset of winter, is expected to continue to appear human infection of H7N9 avian influenza in sporadic cases, Hong Kong will strengthen the prevention and control work, including the strengthening of market or chicken rearing farms security measures to step up temperature screening at customs checkpoints and raise awareness of frontline health care workers and hospital protective measures."

This is an indicator that more is afoot than has been previously admitted too.

The translation also references that NEW CASES (plural) have been reported. HOWEVER, it is unclear if the plural is the correct machine translation.

Ko Wing Man who attended public events, said to the press after a few days ago, Zhejiang an H7N9 confirmed Mainland avian influenza new cases, according to the data, temporarily did not show a change in the virus and a few months ago, is still a major bird viruses, yet found Show will attach person to person.

Updated 10/28/13 to add: We suspect that contaminated
drinking water was a possible H7N9 infection vector for this patient. Given his "hike" through the flood zone, and the reports of floating dead animals, including water fowl, it is likely that Mr Liu ingested water which was contaminated with flood / storm runoff water.

October 3:

Liu is back in Shaoxing, where it is reported he got a rather harsh foot massage.

October 3-6:

Period of overseas travel?

Liu's whereabout are not reported, however it has been reported that he traveled overseas (到外地旅游) prior to symptom onset. http://news.163.com/13/1016/02/9B99EO9F00014Q4P.html. This period would have him returning from overseas travel just prior to Typhoon Fitow coming ashore on Oct 7th.

Noon October 6th:

Liu is reported to have had hearty lunch with his friends at a
Shaoxing
restaurant where he ordered chicken, duck and two beers.

Morning October 7th.

Liu woke up ill with a fever in his company's provided dormitory. He reportedly felt dizzy, hungry, and began vomiting after trying to eat; followed by sweating and "more serious symptoms"

Evening October 7th.

Typhoon Fitow comes ashore approx 1pm local time.
A coworker saw how sick Liu was and went to a nearby pharmacy to pick him up some "anti inflammatory" medicine

October 8th.

Liu went to a local clinic where he was ostensibly diagnosed with a bacterial cold and given cold remedies

October 9-10th

Liu is in the clinic and receiving intravenous saline solution. At this point, it seems as if he is being treated for severe food poisoning.

It is possible that Liu was infected with H7N9 while at this clinc. One wonders how packed this local clinic was with typhoon victims.

October 11th

In the afternoon after receiving more intravenous fluid, Liu feels shortness of breath. The doctors immediately escalate his case, and by 5pm he was transfered to a better equipped hospital. At 6pm Liu calls his brother and asks him come. The brother reports Liu seemed clear headed, but his speaking was laborious and he was panting.

At the emergency room, Liu refuses to go to the ICU to be placed on a ventilator, ostensibly for financial reasons. By 9:40pm Liu is placed in coma via sedation, and finally taken to the ICU where he is placed on a ventilator.

October 12th

Liu is placed on the Critically Ill list

October 13th

Liu's condition had not improved, and by evening time regional CDC staff was brought in for sampling.
Liu is treated twice with Tamiflu

October 14th @23:00

Liu's has tested positive for H7N9 infection.

October 15th

Liu is moved into isolation, negative pressure room, and is considered for "artificial liver treatment"

It is also reported he met with his brother and three friends at a resturant for a Noon lunch on October 6th, he ordered Chicken, Duck, and Beer. On the morning of October 7th he was ill and vomiting.
The doctors blame the victim's H7N9 susceptibility on being fat and tired after his backpacking trip.http://zt-hzrb.hangzhou.com.cn/system/2013/10/16/012585096.shtml
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It is now being reported in the Chinese Media that the recently infected H7N9 patient had traveled abroad prior to symptom onset. It is not yet specified where this individual traveled too / from. but the situation indicates an elevated risk of international spread, and is a potential early warning indicator of impending public health Medical Counter Measures, as such we mark this report as a Maximum Alert.

The individual in question was diagnosed on Oct 8th and had no known exposure to obvious sources of infection. The only indirect risk factor was that the patient drew / sketched / painted outdoor scenery.

The first positive case of H7N9 Bird Flu is being reported by Chinese health authorities.
It is suspected that he was exposed to H7N9 while engaged in sketching / painting wilderness landscapes.http://roll.sohu.com/20131016/n388255348.shtml

There is also a report of large numbers of dead pigs, ducks, chickens and rabbits floating in a near by river (blamed on flooding). We suspect either the deaths, or the flooding (wetland increase) may be tied with the new H7N9 outbreak.

Zhejiang Provincial Health Department on October 15 briefing, Zhejiang new case of human infection of H7N9 avian influenza.
Patients Liu XX, male, aged 35, a company employee, now living in Shaoxing County.October 8 in Shaoxing County township first diagnosed, Shaoxing, now a hospital for treatment.
The provincial CDC retest the patient specimens infected with H7N9 avian influenza virus human nucleic acid positive.I Office of experts on clinical manifestations, epidemiological data and laboratory test results to discuss the diagnosis of avian influenza human infection of H7N9 confirmed cases.Currently, the patient was seriously ill, hospitals are in active treatment.
This is the province since the end of April has been found in the case of human infection of H7N9 avian influenza confirmed cases, my Office will fully organize the rescue work.

Wednesday, October 9, 2013

UPDATE: we are retracting The Province Rumor PART of this report because we have found similar language used in a report generated by a different source in APRIL.

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The Chinese press is openly responding to significant rumors of an H7N9 outbreak, related to a surge in influenza like illnesses in the following provinces "Tangshan, Handan, Baoding, Shijiazhuang, Henan, and other places'.

One key thing to consider about the relationship between influenza-like-illnesses and H7N9 may be found in the last publicly documented H7N9 case. That H7N9 case, a 51 year old woman, had a son who was recovering from an influenza like illness with fever; the son did NOT test positive for H7N9. There may be a significant number of H7N9 cases that are milder and do not test positive for H7N9.

So far the published (propaganda) claims given in response to these H7N9 Outbreak rumors are as follows:

(1) The people are overwrought and the "illness" is a psychological manifestation
(2) The doctors are having a difficult time telling the difference between viral respiratory infections and Air Pollution.
(3) The Chinese CDC has launched an
"comprehensive unexplained pneumonia and influenza-like illness surveillance" emergency plan
(4) The H7N9 "cure rate is very high" if caught early enough.
(5) Poultry and eggs are unmarketable

Obviously something is afoot, whether or not it is H7N9 is to be seen. These large scale widespread rumors would likely induce some higher wealth individuals to flee the affected locations,; thereby making early notice of such event reports important in factoring a potential spread outside of China

Friday, October 4, 2013

The Executive Office of the Presidenthas declared that because of the government shutdown only items which address Imminent threats may be published on the Federal Register. [see video]

In his ever vigilant role as guardian of the nation, and despite the governmental shutdown, President Obama ordered these SEVEN Imminent threats to NATIONAL SECURITY be published TODAY

National Arts and Humanities Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Breast Cancer Awareness Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Cybersecurity Awareness Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Disability Employment Awareness Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Domestic Violence Awareness Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Energy Action Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

National Substance Abuse Prevention Month, 2013

A Presidential Document by the Executive Office of the President on 10/04/2013 PDF

"Due to an appropriations lapse, the Office of the Federal Register (OFR) is not updating this site. OFR is publishing documents in the daily Federal Register that are directly related to the performance of governmental functions necessary to address imminent threats to the safety of human life or protection of property"

Thursday, October 3, 2013

The image below is a map from an analysis which predicts the distribution of H7N9 virus in China, based on a county by county mashup of a myriad of variables correlated to the human outbreak of H7N9 in China.

We (as well as the authors) see some problems / weaknesses with that analysis, but none-the-less the research paper is worth a read because of the raw data alone. We also think the analysis might have been significantly more elucidative had it included directional supply chain and logistics information.

Our quick take on the raw data, is that Chinese poultry markets were a force multiplier for the spread of H7N9 into the Human Population AND INTO THE WILD BIRD POPULATION. Our SWAG is that the transmission vectors went something like this:

Wild bird -> Poultry Market

Poultry Market -> Wild Bird & Human

Human -> Wild Bird, Domestic Bird, & Human

Wild Bird -> Wild Bird & Human

That transmission chain would tend to explain how H7N9 spread around China, and why it grew in urban centers first, rural areas second, and why the geographic disease spread was inverse square'ish at a right angle to the direction of wild bird migration. It would also tend explain why Shanghai was a nexus for transmission even though it appears there were several outbreak initiation points common to wetlands.

Our assessment indicates that preventative closing of urban poultry markets before the wild bird return migration hits full swing, and reducing the illicit trade in wild bird meat, both might make for effective countermeasures.

However, as the non migratory feral bird population already appears widely infected with H7N9, such efforts may quickly be for naught as urban fecal contamination from pigeons and sparrows may reignite human H7N9 infections as temperature and humidity changes make transmission more amenable during the season change.